Appendicitis

Diagnosis of appendicitis

Your doctor will help diagnose your appendicitis first by taking a history of your symptoms. They will conduct a physical exam to assess your pain. During this exam, they will likely apply gentle pressure on the painful area of your abdomen. When they release the pressure, the pain will often be worse. This signals that the peritoneum, the lining of the abdomen, is inflamed. They will also look for rigidity or guarding in your abdominal muscles.

Women who are able to have children may additionally have a gynecological exam to check for other problems that could be causing this pain, such as an ovarian cyst.

Your doctor may additionally conduct a blood test to check for infection and a urine test to rule out a urinary tract infection or kidney stone. Imaging tests are useful to confirm appendicitis or show other possible causes of your pain. Standard imaging tests include ultrasound, CT scan, and MRI scan.

Treatment  

Your treatment options will depend on whether or not your appendix has burst. Immediate surgery is the usual treatment for appendicitis because of the high risk of rupture. An inflamed appendix can rupture as soon as 48 to 72 hours after symptoms first start. When this happens, an infection can spread throughout the belly and cause a life-threatening condition called peritonitis. An appendectomy will prevent or treat this complication.

In some cases, people don’t realize they have appendicitis until their appendix bursts. This is more common in the very young or the very old. It’s also more common during pregnancy. If your appendix ruptures, you can become very ill very quickly. Surgery to remove the appendix and clean out the belly is necessary. Your hospital stay will likely be longer if your appendix ruptures.

There are two types of surgeries to remove the appendix: 

  • Laparoscopic appendectomy is the less invasive method, where the procedure is conducted through smaller incisions. This method will likely lead to less pain and scarring, with quicker recovery time and lower infection rates.
  • Open appendectomy is when a 2 to 4-inch long incision is used to take out the infected appendix. If your appendix has ruptured or the infection has spread, you may need an open appendectomy.

Both surgeries are low risk. It is possible that during a laparoscopic procedure, your surgeon will decide that you need an open appendectomy. The rate at which your symptoms arrived does not relate to the type of surgery you may need. The type of surgery will depend mainly on how complex your case has become in regards to spreading of infection.

If your appendix bursts, it is possible that an abscess will form around it. This abscess will need to be drained before an appendectomy takes place. Your care team will place a tube through your skin to drain the abscess and clear out the infection. 

Recovery  

You can expect to spend one or two days in the hospital after an appendectomy for monitoring. It will take a few weeks to recover fully, possibly longer if your appendix burst. There are measures that you can take to help your body through the healing process:

  • Support your abdomen. If you need to cough or laugh, place a pillow over your abdomen and apply gentle pressure to reduce pain.
  • Avoid strenuous activity. Your doctor will give you exact instructions and a timeline, but generally expect to limit activity for three to 14 days, depending on your surgery.
  • Listen to your body. You may be more tired than usual, and it is important to sleep when you need to. This will allow your body to heal. When you feel ready, get up and start with short walks to introduce activity. It is essential not to push your recovery.
  • Discuss returning to activities with your doctor. Generally, when you feel up to it, you will be able to return to work or school. Children should wait two to four weeks to resume activities such as gym class or sports.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.